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“I Am The Expert” : The Process Of Adolescent Transition In The Self-Management Of Hearing Healthcare. A Constructivist Grounded Theory Study, Christine N. Meston

Electronic Thesis and Dissertation Repository

Adolescence is a time when adult behaviours become established and adolescents are more able to manage aspects of their healthcare. Research has examined adolescent transitions to self-manage their personal healthcare needs associated with chronic diseases. Providing children and adolescents with information about their health is an ongoing process and, as they mature, they should be allowed to take on more responsibility for their healthcare management. The purpose of this study was to explore the transition for adolescents who are deaf and hard of hearing toward the self-management of their hearing healthcare. A constructivist grounded theory approach was used to develop …

Uncovering Deficits In Auditory Processing And Cognition Following Hearing Loss And Prefrontal Cortex Dysfunction, Krystyna B. Wieczerzak

Electronic Thesis and Dissertation Repository

How the auditory cortex and higher-order cortical regions, e.g., the prefrontal cortex, interact for accurate auditory processing and perception is not fully understood. Furthermore, although hearing loss is correlated with cognitive impairment, and animal studies have shown that loud noise exposure causes hippocampal neuropathology, the effects of noise-induced hearing loss on the medial prefrontal cortex (mPFC) and higher-level cognitive functions have not been well studied. Using electrophysiological and cognitive-behavioural testing in rats, Chapter 2 provides the first evidence of noise-induced plasticity in the mPFC (e.g., loss of functional connectivity with the auditory cortex) and deficits in stimulus-response habit learning. Although …

Cognitive Resources Are Recruited Consistently Across People During Story Listening, Matthew T. Bain

Electronic Thesis and Dissertation Repository

Degraded speech encoding as a result of hearing loss increases cognitive load and makes listening effortful. Standard hearing assessment does not capture this cognitive impact of hearing impairment. Speech-in-noise testing measures intelligibility for isolated sentences that are typically not engaging and lack meaningful context. These materials may not capture the processes involved in everyday listening situations, in which people are often intrinsically motivated to comprehend the speech they are hearing. The current study explored a novel approach using natural, spoken stories. We first characterized time courses of executive load during story listening in young individuals with normal hearing using a …

Advanced Phenotyping Of Otosclerosis In An Ontario Population And Two Large Newfoundland Families, Matthew B. Lucas

Electronic Thesis and Dissertation Repository

Otosclerosis is a relatively common hearing loss disorder characterized by abnormal bone growth in the otic capsule leading to stapes fixation. In approximately half of cases, otosclerosis is inherited as an autosomal dominant trait. Typically, gene discovery efforts rely on surgical confirmation, audiometry and occasionally acoustic reflexes to identify affected cases of otosclerosis within families, requiring that the otosclerosis was at an advanced stage to be detected. This makes it difficult to identify individuals with early otosclerosis. The use of advanced phenotyping to identify cases of otosclerosis was tested in an Ontario otosclerotic population as well as in two large …

Investigating The Relationship Between Subcortical And Cortical Auditory Processing, Sonia Varma

Electronic Thesis and Dissertation Repository

The auditory system is highly integrative, with feedforward and feedback connections from periphery to cortex (and stages in between). In order to understand how the different levels of the human auditory system interact, it is necessary to simultaneously measure responses from multiple auditory levels. A novel stimulus was paired with electroencephalography (EEG) in 29 young, normal-hearing participants (17-34 years) to examine interactions among stages of the auditory pathway. Temporal regularity was manipulated by continuously accelerating and decelerating the rate of a click-train stimulus (i.e., ~3.5 Hz frequency modulation of the click rate). Adaptation of the brainstem (cochlear nucleus and inferior …

Understanding Hearing Aid Sound Quality For Music-Listening, Jonathan Matthew Vaisberg

Electronic Thesis and Dissertation Repository

To improve speech intelligibility for individuals with hearing loss, hearing aids amplify speech using gains derived from evidence-based prescriptive methods, in addition to other advanced signal processing mechanisms. While the evidence supports the use of hearing aid signal processing for speech intelligibility, these signal processing adjustments can also be detrimental to hearing aid sound quality, with poor hearing aid sound quality cited as a barrier to device adoption. Poor sound quality is also of concern for music-listening, in which intelligibility is likely not a consideration. A series of electroacoustic and behavioural studies were conducted to study sound quality issues in …

Cortical Plasticity Following Adult-Onset Hearing Loss, Ashley L. Schormans

Electronic Thesis and Dissertation Repository

The consequences of hearing loss are not confined to how the central auditory system processes sound; crossmodal plasticity also occurs, which is characterized by an increased responsiveness of neurons in auditory areas to visual and/or tactile stimuli. In the primary auditory cortex, partial hearing loss causes a decrease in the number of auditory-responsive neurons, as well as an increase in multisensory neurons. However, it was relatively unknown how adult-onset hearing loss affected cortical areas that are already capable of integrating multisensory information, such as the lateral extrastriate visual cortex (V2L). Using a combination of in vivo electrophysiology, neuropharmacology and behavioural …

The Listening Shift: Evaluating A Communication-Strategies Training Program For Telepractice Nurses Experiencing Hearing Challenges, Raphaelle Koerber

Electronic Thesis and Dissertation Repository

Workers who wish to remain employed should be supported in doing so, even if they are experiencing age-related disabilities, such as hearing loss. I aimed to better understand the strategies from which workers with hearing loss might benefit, and how they can be supported in adopting these strategies. To collect rich data, I recruited telepractice nurses who rely on listening to make critical decisions about triaging and health care recommendations. My first research question was: What strategies exist for making telephone speech more intelligible for health care providers and patients with hearing challenges? I performed a scoping review following the …

Manipulation Of Auditory Feedback In Individuals With Normal Hearing And Hearing Loss, Le Truc Linh Vaccarello

Electronic Thesis and Dissertation Repository

Auditory feedback, the hearing of one’s own voice, plays an important role in the detection of speech errors and the regulation of speech production. The limited auditory cues available with a hearing loss can reduce the ability of individuals with hearing loss to use their auditory feedback. Hearing aids are a common assistive device that amplifies inaudible sounds. Hearing aids can also change auditory feedback through digital signal processing, such as frequency lowering. Frequency lowering moves high frequency information of an incoming auditory stimulus into a lower frequency region where audibility may be better. This can change how speech sounds …

Accessing Resources: The Narratives Of Women Working With A Hearing Loss, Ashley Martindale

Electronic Thesis and Dissertation Repository

This narrative study describes the stories of women who are experiencing a hearing loss while working. It seeks to understand why these women may or may not be accessing resources. A narrative approach was used in order to gain in-depth description of the experiences of the participants. Two one-on-one interviews were completed with each of the eight participants.

After analysis of the interviews, five themes emerged. These themes included degree of hearing loss and communication demands, childhood experiences, financial factors, knowledge and awareness of others, and workplace environments. Insights of this “invisible” disability as well as ways in which women …

Exploring The Self-Regulatory Behaviors Of Elementary Students With Hearing Loss In Inclusive Classrooms, Kendra Di Bacco

Electronic Thesis and Dissertation Repository

An exploratory, mixed-method and multi-level research design was employed to examine relationships among students’ hearing loss, academic achievement and self-regulation (SR), classroom background noise levels, teachers’ perceptions of inclusion of students who are hard of hearing (HH) and features of classroom instruction that support SR. Data consisted of 10 elementary teachers’ perceptions of the inclusion, and ratings of 131 students’, of whom 8 were hard of hearing, SR and academic achievement scores. Classroom observations were conducted to obtain background noise levels and to examine whether and how teachers implement the features of classroom contexts to support SR within their classroom. …

Predictors Of Language Outcome For Children In The Ontario Infant Hearing Program, Olivia M. Daub

Electronic Thesis and Dissertation Repository

The Ontario Infant Hearing Program (OIHP) provides early interventions (i.e., hearing aids) to children who are hard of hearing (CHH) because research consistently demonstrates their benefit to language outcomes. The impact of pre-fitting language abilities on these outcomes are not well understood.

This retrospective cohort analysis examined the performance of OIHP children on the Preschool Language Scale-4 at the time of (n=47), and after (n=19), initial hearing aid intervention. Regression analyses revealed that, before amplification, hearing loss severity predicted language abilities. However, after amplification, severity of hearing loss did not uniquely predict language achievement, but rather …

Factors In The Client-Clinician Interaction That Are Perceived To Influence Hearing Aid Adoption In First Time Hearing Aid Candidates And Their Rated Importance By Clients And Clinicians, Laya Poost-Foroosh

Electronic Thesis and Dissertation Repository

The purpose of this dissertation was to gain a better understanding of the impact of the client-clinician interaction in the hearing aid adoption process. The specific goals of this dissertation were: 1) to identify factors in client-clinician interactions that were perceived by clients and clinicians to influence hearing aid adoption in first time adult hearing aid candidates, 2) to investigate the importance of the identified factors from clients and clinicians perspectives, and 3) to compare the importance of the identified factors between clients and clinicians. These goals were achieved using a mixed-methods approach.

Three studies were undertaken. In the first …

An Integrated Knowledge Translation Experience: Use Of The Network Of Pediatric Audiologists Of Canada To Facilitate The Development Of The University Of Western Ontario Pediatric Audiological Monitoring Protocol (Uwo Pedamp V1.0)., Sheila T F Moodie

Electronic Thesis and Dissertation Repository

The goals of this project were: (1) to determine the important factors that influence implementation of evidence-based practice by Canadian audiologists; and (2) to utilize the knowledge-to-action process (Graham et al., 2006) during the development of a guideline for outcome measures to evaluate the auditory development and performance of young children who wear hearing aids, to facilitate clinical uptake and identify barriers to implementation (Bagatto, Moodie & Scollie, 2010; Bagatto et al., 2011; Bagatto, Moodie, Seewald, Bartlett, & Scollie, 2011; Moodie, Bagatto et al., 2011; Moodie, Kothari et al., 2011).

Two projects (Chapters 3 and 4) included the participation of …